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Acanthamoeba keratitis management in pregnant women: a case report

Poster Details

First Author: C.Spinola Munoz SPAIN

Co Author(s):    M. Caro Magdaleno   B. Mataix Albert   J. Montero Iruzubieta   E. Rodriguez De La Rasa Franch   R. Perea Perez        

Abstract Details

Purpose:

There is little evidence about the management and treatment of Acanthamoeba keratitis in pregnant women. Our purpose is to provide our expertise in this field through a case treated in our center.

Setting:

We report the case of a 29 years, 7 months pregnant woman, with contact lenses, that goes to a tertiary hospital in the month of February 2014. Hospital Virgen Mcarena, Spain

Methods:

The patient complains of photophobia, redness and severe pain in right eye two weeks of evolution. She had previously undergone treatment with antibiotic eye drops and topical steroids without improvement. Eye examination showed a decrease in visual acuity, moderate ciliary injection, corneal edema and bullous component perineural infiltration and VIII to XII hours. Considering that the patient is pregnant , confocal microscopy is performed before treatment, showing trophozoitic forms. The diagnosis of Acanthamoeba keratitis is established, being subsequently ratified by the results of the cultures of corneal scrapings and contact lens set .

Results:

To avoid systemic absorption of topical treatment and reduce the teratogenic risk , punctal plugs silicone were placed , later replaced by painless S24002 plugs. Treatment was initiated with propamidine isetionate 0,1%, chlorhexidine 0.02 % and azithromycin eye drops. Two weeks after the patient had subjective improvement. An improvement is seen in visual acuity and the cornea examination.

Conclusions:

Given the potential risk of the treatments used in this disease in pregnant women, it increases the importance of prior diagnostic confirmation. We propose confocal microscopy as a choice. Therefore, we propose implantation of punctal plugs during treatment with topical chlorhexidine, propamidine isetionate and antibiotic coverage as a good alternative in this cases.

Financial Disclosure:

NONE

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